A rare formation of renal calculi like a mushroom

Abstract

To the Editors, A 65­year­old male patient was referred to our institute for the treatment of his left ureteral and renal calculi (Figure 1A–B). After two months, he was admitted to our department for treating his left ureteral and renal calculi with ureteroscopic lithotripsy using a holmium yattrium aluminum garnet (Ho: YAG) laser. After inserting ureteral access sheath, we firstly made stone fragment and retracted them in the ureter using rigid ureteroscope (URS) with Ho: YAG laser lithotripsy. There after, we observed the renal collecting system using flexible URS. In the view of flexible URS findings, renal stones were formed like mushrooms (Figure 2). Because of large stone volumes, we made stone fragments and retracted them in the second session of URS one month after initial treatment. In general, ureteral and renal stones were usually formed as a round ball, except for the large renal staghorn calculi. Our institute is a large referral stone disease center in Japan, more than 400 shockwave lithotripsy (SWL), 300 URS and 80 percutaneous nephrolithotomy (PCNL) were performed per year. LETTER TO EDITORS OPEN ACCESS